Some of dentistry's greatest technological advances occurred in the late fifties and early sixties with the initial development of dental implant and prosthetic technology. This technology provided an alternative to the old method of tooth extraction and replacement dental prosthetics (e.g., removable prosthetics such as dentures held in place by adhesive or suction and non-removable prosthetics such as bridges that are affixed to remaining healthy teeth). The older method generally had reached its limitations at that time in that hand-created and fitted dentures could be easily dislocated and make embarrassing “clicking” sounds; contribute to bone loss; and could be ill fitting and painful. Bridges could be uncomfortable and annoyance to the patients in their means of attachment as well as possibly damage healthy teeth to which they were attached.
Dental implant technology has made it possible to replace the extracted tooth with a prosthetic or artificial tooth (e.g., a crown) that is anchored in the bone of the mouth. In this technology, an anchoring means is generally a dental implant comprising of a specially-shaped and constructed post (generally made of titanium, whose qualities allow it to bond well with the bone-a process called osseointegration) that is placed into the bone structure of the mouth to act as the “root(s)” of the prosthetic tooth. This placement generally allows a portion of the implant to protrude above the gum line where it is generally surrounded by an structure called an abutment or extension that acts as an adaptive interface for the crown (the prosthetic that is constructed to look like that portion of the tooth, which that is visible in the mouth). This abutment ensures the crown is held in the proper orientation and placement once the crown is permanently affixed to the implant.
Currently, the dental implant technology requires a significant amount of preparation, time, as well as a significant amount of talent, skill, knowledge on behalf of the dental healthcare professional (e.g., the dentist) to ensure that the proper implant placement and proper crown attachment occurs. This is necessary to maintain the patient's correct and proper bite (e.g., the alignment between the mandible and upper plate of the patient mouth.) and to proper dental look. If the proper alignment is not maintained with the newly placed implant, then the patent can be placed into constant pain with misaligned bite as well as suffer premature mandible joint wear. Further, this dental capability is necessary during implant surgery (e.g., drilling, boring, threading the pilot hole for the implant) to prevent damage to critical jaw and facial structures such as the inferior alveolar nerve in the mandible (e.g., the lower jaw).
Traditionally, to accomplish these adjectives, a casting or impression of the patient's mouth is taken, along with dental X-rays to aid in the planning and directing of the implant surgery. To further ensure proper placement of the implant, abutment, and crown, additional new technologies have developed using CT-scanning capability to digitally scan a patient's mouth to create datum data. Using this digital data, plus manual data obtained from castings of the patient's mouth, various specialized 3D Cad/Cam computer programming can recreate a virtual, as well as a physical model, of the patient's mouth to prepare the overall implant surgical plan for placement of one or more dental implant(s) in the patient's mouth.
In addition, an overlaying dental surgical guide, also known as a stent, substantially created in the same manner as the model (using CT scanning data or manual creation), can fit over the patient's teeth, bone surface, or mucosa (if all the teeth are missing). This dental surgical guide could have one or more CT-designed hollow channels containing reinforcement tubes or grommets that generally connect the top of the dental surgical guide to the bottom of the dental surgical guide. The passages or hollow interiors in the grommets can generally guide the dentist's placement of the dental implant appliances (e.g., the tools used to prepare and secure the implant in the patient's mouth). Even when using such a top-loading dental surgical guide, the dental health care professional (e.g., dentist) still needs to possess and exercise considerable skill and artistry to correctly locate, orient, and secure the implant into the mouth bone structure as the dentist still has to properly angle the dental implant appliances correctly though the top-loading dental surgical guide. In this manner, the precision of such systems can be seen as being limited.
Another issue generally effecting implant surgery is that dental surgical guide (either CT-based or manually created) generally adds its own thickness and may substantially limit the availability of oral cavity area that is needed to perform those operations for placing the implant. This current limitation may require the patient to open their mouth even further to accommodate the dental implant appliances and the like than if the dental surgical guide was not employed in the first place. While this may not be much of concern regarding implants for lost forward teeth, it can have significant impact for back teeth implant placement, where the patient may be required to open their mouth wider than normal for implant placement resulting in possible over stretching of the temporal mandible joint with resulting significant discomfort, as well as possible physical injury to the patient.
What is needed therefore is a dental surgical guide that can be created using CT-based three-dimensional imaging of the patients mouth (combined with impression-based models) that allows for precisely created and placed aperture(s) and corresponding grommet(s) within the dental surgical guide that allow the dental surgical guide to incorporate a wide variety of datum or implant placement control factors such setting the depth of the implant, its x, y, and z axial orientations, telemetry, and the like in the mouth's bone structure. Such incorporation, provided in step with a side-loading dental surgical guide with resultant and high precision locating/locking means, could allow the computer-processed datum/implant placement control factors to be utilized in the orientation and operation of dental implant appliances, implant, and implant-related items. This side-loading dental surgical guide system could further incorporate various operator notification means (e.g., audible, tactile, and the like) to inform the operator when correct placement, orientation, and operation of the dental implant appliance/implant has been accomplished.
To further facilitate the ease of the implant placement, the use of side-loading dental surgical guide system could provide for the relieved insertion of implant appliances, implant, and implant-related items through the side rather than the top of the dental surgical guide to allow for greater operating room in the mouth as well as not requiring the patient to significantly open their mouth further to accommodate the insertion of tools/implant into the dental surgical guide.
With these qualities, the side-loading dental surgical guide system could provide a level of control and precision over the planning, guidance, and placement of the implant to a degree previously unheard. This greatly improved capability could significantly increase the ease of the dental implant operation; reduce the time and number of individual operations required for the dental implant operation; reduce the dental implant placement recovery time while overall, increase the dental healthcare professional's implant surgery capability. Such a capability could accomplish this by significantly replacing a large amount of dental art (skill and talent) ordinarily required for the completion of such dental implant surgical operations with computer-controlled, consistent, accurate, scientific precision. The overall result of such a system could provide affordable implant surgery to significantly greater numbers of the public suffering from tooth loss than ever before.